The old traditional Adsoft eartips are made with PVC and feature integrated threading that will allow them to thread onto Adscope stethoscopes manufactured before 2014. While comfortable and secure, these eartips can loosen over time and require that the end user perform minimal maintenance in the form of tightening the eartips on their threading. New Adsoft Plus eartips are made of silicon and feature an adapter that the eartip snaps onto. Supplied with newer Adscope stethoscopes manufactured in 2014 or later, these eartips cannot loosen over time as their adapters are permanently affixed to the ends of the aural tubes.